View full sizeAssociated Press fileLate-night texting can lead to medical problems.CLEVELAND, Ohio -- Parents of teenagers worry about their kids and drugs, their kids and alcohol, their kids and sex. Now they can add one more thing to the list: texting.

Every day, pediatricians and sleep clinics treat kids for all kinds of problems brought on -- or worsened -- by hours of middle-of-the-night message sending.

What they're seeing, they say, are more and more teens and tweens texting until 2 or 3 a.m., dragging themselves out of bed at 6, struggling through the school day, then falling into bed as soon as they get home. Often, they nap straight through dinner. That means they're wide awake when they should be going to bed. Then they start texting again.

And the cycle continues, night after night, week after week until their lives begin to unravel.

When they miss school, they increase their chances of messing up their futures, too.

"Those are the kids that get in trouble with the law or in trouble in the neighborhood," Stager says. "It's a cascade effect."

It's a pattern Landis also sees. And it's one that disturbs her, too.

"When you see the worst-case scenario, the kids that I see, it's just truly sad," she says. "These are college-material kids. How are you going to get into college when you are flunking out of school?"

Kids' constant communication puts them at risk

Just as worrisome are the physical problems the lack of sleep can cause.

Study after study has found a link between too little sleep and obesity.

And more studies have found a link between obesity and serious health problems including heart disease, diabetes and cancer.

Being tired all the time affects mental health, too.

"If there's any baseline mental-health issue like anxiety or depression, you begin to trigger the stress factors that are going to make those mental-health problems worse," Stager says.

Landis has seen another problem crop up, too.

"I have kids who come in and look like they're depressed, but they're not. They're just sleep deprived.

"There's the possibility of a child getting diagnosed -- and even getting on medication -- and they don't necessarily have the [mental] disorder."

Stager worries about what happens to these kids socially, as well.

"If they're getting that long sleep after school, they're not sitting down with the family at the table," Stager says. "And we know that the kids who eat family dinner have less high-risk behavior."

Research, she says, shows children who share regular meals with their families are less likely to use alcohol or drugs and more likely to be successful in school.

"There's a lot of advantages to that family time," Stager says. "It's just thought to be related to connectedness -- feeling connected to that home or home base or family."

All these problems call for parents to step in.

"The key message," Stager says, "is that parents have to play a much more active role in getting those electronics -- whether it's a TV, a computer, a cell phone or a hand-held game system -- out of the children's bedroom where they can play unmonitored around the clock. I see parents having a major role here in providing very meaningful oversight for kids who just don't have the maturity to make healthy decisions about their use of technology."

Landis agrees.

So does Dr. Donald Shifrin, a Seattle pediatrician and spokesman for the American Academy of Pediatrics.

That doesn't mean these doctors are against cell phones.

"I have very passionately said to parents who are not getting their children cell phones 'This is a necessity,' " Shifrin says. "If your child doesn't have this, they're going to be looked at as an outlier, as socially awkward. But you don't have to buy a cell phone that's programmed to do everything."

What should parents do?

Still, experts agree, parents have to be parents when it comes to this issue.

So what should they do?

Shifrin offers step-by-step advice:

1. Be a good role model. "When you come home for dinner, don't be BlackBerrying or iPhoning during dinner," he says. "Put the devices away so you can actually have a conversation."

2. Make meal time an electronic-free zone. No cell phones, no TV, no radio, no iPods. "We want to unplug children on occasion," he says. "The only way we can talk to our children is if we have their attention. And the only waywe can get their attention is if we minimize distraction."

3. Negotiate an electronic curfew with your children. Tell your children there's no texting after 10 or 11 p.m. -- you pick the time. Then make them hand over their phone. Telling them you trust them but you can't control their friends makes it easier.

4. If things get out of hand, ground them -- digitally. Discontinue your child's texting service by contacting your cell-phone company. "I guarantee you, if you take texting away, your youngster will be coming to see you," Shifrin says. And once you have his or her attention, you can talk about the problems texting is causing.

5. When talking about those problems, keep it lighthearted and start with the word "I," not "you." Don't say "You're staying up all night," or "You're not doing well in school," Shifrin says. That puts kids on the defensive and shuts them down. Instead, try things like "I see that your grades are falling," "I'm worried about your health" or "I'm worried that you're falling asleep when you get home from school, that this is not a good path that you're on." Pediatricians know kids will fight parents on this, that they'll say everybody else is doing it, that they'll complain about losing all their friends if they don't.

That's why Landis offers one more suggestion.

"Parents unite," she says. "Let's say no more texting after 11. That would be easier for children, because they wouldn't be the unpopular one or the nerdy one or the one with the uncool parents."

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